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1.
PeerJ Comput Sci ; 9: e1534, 2023.
Article in English | MEDLINE | ID: mdl-37705667

ABSTRACT

The environmental damage caused by air pollution has recently become the focus of city council policies. The concept of the green city has emerged as an urban solution by which to confront environmental challenges worldwide and is founded on air pollution levels that have increased meaningfully as a result of traffic in urban areas. Local governments are attempting to meet environmental challenges by developing public traffic policies such as air pollution protocols. However, several problems must still be solved, such as the need to link smart cars to these pollution protocols in order to find more optimal routes. We have, therefore, attempted to address this problem by conducting a study of local policies in the city of Madrid (Spain) with the aim of determining the importance of the vehicle routing problem (VRP), and the need to optimise a set of routes for a fleet. The results of this study have allowed us to propose a framework with which to dynamically implement traffic constraints. This framework consists of three main layers: the data layer, the prediction layer and the event generation layer. With regard to the data layer, a dataset has been generated from traffic data concerning the city of Madrid, and deep learning techniques have then been applied to this data. The results obtained show that there are interdependencies between several factors, such as weather conditions, air quality and the local event calendar, which have an impact on drivers' behaviour. These interdependencies have allowed the development of an ontological model, together with an event generation system that can anticipate changes and dynamically restructure traffic restrictions in order to obtain a more efficient traffic system. This system has been validated using real data from the city of Madrid.

2.
Conserv Biol ; 37(4): e14094, 2023 08.
Article in English | MEDLINE | ID: mdl-37021395

ABSTRACT

Evaluating the outcomes and tracking the trajectory of biodiversity offsets is essential to demonstrating their effectiveness as a mechanism to conciliate development and conservation. We reviewed the literature to determine the principles that should underpin biodiversity offset planning and the criteria for offset evaluation at the project level. According to the literature, the core principles of equivalence, additionality, and permanence are used as criteria to evaluate conservation outcomes of offsets. We applied the criteria to evaluate offsets of a large iron ore mining project in the Atlantic Forest in Brazil. We examined equivalence in terms of the amount of area per biodiversity value affected and fauna and flora similarity, additionality in terms of landscape connectivity, and permanence in terms of guarantees to ensure protection and restoration offsets lasting outcomes. We found an offset ratio (amount of affected area:offset area) of 1:1.8 for forests and 1:2 for grasslands. Ecological equivalence (i.e., similarity between affected and offset areas) was found for forested areas, but not for ferruginous rupestrian grasslands or for fauna. Landscape metrics showed that connectivity improved relative to the preproject situation as a result of locating restoration offsets in the largest and best-connected forest patch. Permanence of offsets was addressed by establishing covenants and management measures, but financial guarantees to cover maintenance costs after mine closure were lacking. Offsets should be equivalent in type and size, provide conservation outcomes that would not be obtained without them (additionality), and be lasting (permanence). To monitor and evaluate offsets, it is necessary to determine how well these 3 principles are applied in the planning, implementation, and maintenance of offsets. Achieving measurable conservation outcomes from offsets is a long-term endeavor that requires sustained management support, and is information intensive. Thus, offsets require ongoing monitoring and evaluation as well as adaptive management.


Evaluación del potencial de las compensaciones por biodiversidad para obtener ganancias netas Resumen La evaluación de resultados y el rastreo de la trayectoria de las compensaciones por biodiversidad son esenciales para demostrar su efectividad como mecanismo de conciliación entre el desarrollo y la conservación. Revisamos la literatura para determinar los principios que deberían sustentar los planes de compensación y los criterios para evaluarla a nivel de proyecto. Según la literatura, se usan los principios nucleares de equivalencia, adicionalidad y permanencia como criterio para evaluar los resultados de conservación de las compensaciones. Aplicamos este criterio para evaluar las compensaciones de un gran proyecto minero de mineral de hierro en el Bosque Atlántico de Brasil. Analizamos la equivalencia en términos de cantidad de área por valor de biodiversidad afectado y similitudes entre la flora y fauna; la adicionalidad en términos de conectividad de paisaje; y la permanencia en términos de las garantías que aseguran que las compensaciones tengan resultados longevos de restauración y protección. Descubrimos una proporción en las compensaciones (cantidad del área afectada:área de compensación) de 1:1.8 para los bosques y de 1:2 en los campos naturales. Encontramos equivalencias ecológicas (es decir, la similitud entre las áreas afectadas y las de compensación) para las áreas boscosas, pero no para los campos rupestres ferruginosos ni para la fauna. Las medidas del paisaje mostraron que la conectividad mejoró en relación a la situación previa al proyecto gracias a la ubicación de las compensaciones por restauración en los fragmentos de bosque más grandes y mejor conectados. Establecimos Contractos y medidas de manejo fueron establecidos la permanencia de las compensaciones, pero las garantías económicas para cubrir los costos de mantenimiento después del cierre de la mina no están suficientemente garantizadas. Las compensaciones deberían ser iguales en tipo y tamaño (equivalencia), proporcionar resultados de conservación que no se obtendrían en su ausencia (adicionalidad) y ser duraderas (permanencia). Se necesita determinar cómo se aplican estos tres principios en la planeación, implementación y mantenimiento de las compensaciones para poder monitorearlas. Si se quieren lograr resultados medibles de conservación, se necesita que el manejo cuente con un apoyo mantenido y a largo plazo que contenga con información intensiva. Por lo tanto, las compensaciones requieren un monitoreo y evaluación continua además del manejo adaptativo.


Subject(s)
Biodiversity , Conservation of Natural Resources , Forests , Mining , Brazil , Ecosystem
3.
Environ Manage ; 71(2): 483-493, 2023 02.
Article in English | MEDLINE | ID: mdl-36459196

ABSTRACT

The application of the mitigation hierarchy (MH) to mining projects is challenging in situations of locational overlap between endemic flora and mineral deposits. We review flora surveys conducted in connection with the environmental impact assessment of several iron ore mining projects in an area of high degree of endemism in Eastern Amazon to discuss the practical implications of anticipating conservation strategies. Desktop studies and secondary data review were conducted to guide field searches to determine the distribution of endemic flora, resulting in 45 out of 46 endemic plant species having their known distribution extended to new areas. A framework for positioning flora conservation strategies in the MH is presented. Specific habitat requirements and scarce knowledge about endangered and endemic flora species are a conservation obstacle, since essential information to define species conservation strategies may be lacking. We show that anticipating conservation strategies can minimize time-lag uncertainties related to restoration success and biodiversity offsets. The more effort is placed in the preventative steps of the MH, the smaller the time-lag between impact (biodiversity losses) and conservation outcomes (biodiversity gains), decreasing uncertainties and reducing risks to biodiversity.


Subject(s)
Conservation of Natural Resources , Ecosystem , Conservation of Natural Resources/methods , Biodiversity , Mining
5.
ACS Omega ; 7(27): 23591-23604, 2022 Jul 12.
Article in English | MEDLINE | ID: mdl-35847323

ABSTRACT

Cerenkov radiation (CR) can be used as an internal light source in photodynamic therapy (PDT). Methotrexate (MTX) and paclitaxel (PTX), chemotherapeutic agents with wide clinical use, have characteristics of photosensitizers (PS). This work evaluates the possibility of photoexciting MTX and PTX with CR from 18F-FDG to produce reactive oxygen species (ROS) capable of inducing cytotoxicity. PTX did not produce ROS when excited by CR from 18F-FDG, so it is not useful for PDT. In contrast, MTX produces 1O2 (detected by ABMA) in amounts sufficient to significantly decrease the viability of the T47D cells. MTX solutions of 100 nM combined with 18F-FDG activities of 50 (1.85 MBq) and 100 µCi (3.7 MBq) produced a significant decrease in cell viability to (50.09 ± 4.95) and (47.96 ± 11.19)%, respectively, compared to MTX (66.29 ± 5.92)% and 18F-FDG (91.35 ± 7.00% for 50 µCi and 99.43 ± 11.03% for 100 µCi) alone. Using the CellRox Green reagent, the intracellular production of ROS was confirmed as the main mechanism of cytotoxicity. The results confirm the therapeutic potential of photoactivation with CR and the synergy of the combined treatment with chemotherapy + photodynamic therapy (CMT + PDT). The combination of chemotherapeutic agents with PS properties and ß-emitting radiopharmaceuticals, previously approved for clinical use, will make it possible to shorten the evaluation stages of new CMT + PDT systems.

6.
Arch. pediatr. Urug ; 93(1): e201, jun. 2022. tab
Article in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1383630

ABSTRACT

Introducción: se describe a nivel mundial un aumento en la prescripción de macrólidos en niños y adolescentes, generando el riesgo de emergencia de cepas resistentes. Objetivo: caracterizar el uso de macrólidos en niños de 1 mes a 14 años hospitalizados en cuidados moderados e intensivos del Hospital Pediátrico del Centro Hospitalario Pereira Rossell (HP-CHPR). Metodología: estudio descriptivo transversal de niños hospitalizados tratados con macrólidos en el HP-CHPR en 2018. Variables: tipo de macrólido, duración del tratamiento, estudios y hallazgos microbiológicos y diagnóstico al egreso. Resultados: recibieron macrólidos 334 niños, mediana de edad 13 meses, 58,4% varones. 71,0% en Unidad de Terapia Intensiva (UTI). Predominó la prescripción de claritromicina (72,8%), durante los dos últimos cuatrimestres del año (77,5%) y por patología respiratoria (94%): bronquiolitis (23,3%), infección aguda no especificada de las vías respiratorias inferiores (21,9%) y crisis asmática (19,1%). Mediana de tratamiento con azitromicina y claritromicina 5 y 8 días respectivamente. Se realizaron estudios microbiológicos en 96,1% sin determinarse microorganismo en 58,3%. Conclusiones: se destaca el uso de macrólidos principalmente en la UTI y por patología respiratoria. La prescripción por fuera de las recomendaciones nacionales vigentes y la baja confirmación microbiológica que apoye el uso fueron los mayores problemas detectados, por lo que parece fundamental establecer estrategias tendientes a promover un uso racional de estos antibióticos.


Introduction: literature has described a global increase in the prescription of macrolides to children and adolescents , which has increased the risk of emergence of resistant strains. Objective: to characterize the use of macrolides in children from 1 month to 14 years of age hospitalized at the moderate and intensive care units of the Pereira Rossell Pediatric Hospital Center (HP-CHPR). Methodology: descriptive cross-sectional study of hospitalized children treated with macrolides at the HP-CHPR in 2018. Variables: macrolide type, treatment duration, microbiological studies and findings, and diagnosis at discharge. Results: 334 children received macrolides, median age 13 months, 58.4% males. 71.0% hospitalized atnan Intensive Care Unit (ICU). Clarithromycin was mainly prescribed in 72.8% of the cases, during the last two quarters of the year (77.5%), due to respiratory disease (94%): bronchiolitis (23.3%), lower respiratory tract unspecified acute infection (21.9%) and asthma crisis (19.1%). Median treatment included Azithromycin and Clarithromycin for 5 and 8 days respectively. Microbiological studies were carried out in 96.1% of the cases and 58.3% did not show the presence of microorganisms. Conclusions: the use of macrolides stands out, mainly at ICUs and due to respiratory pathologies. The main problems identified were prescriptions made outside the framework of the present national recommendations and the low microbiological confirmation for their use, which suggests it is essential to set strategies to promote a more rational use of these antibiotics.


Introdução: a literatura descreve um aumento a nível global na prescrição de macrolídeos para crianças e adolescentes, o que tem aumentado o risco de surgimento de cepas resistentes. Objetivo: caracterizar o uso de macrolídeos em crianças de 1 mês a 14 anos de idade internadas nas unidades de terapia moderada e intensiva do Centro Hospitalar Pediátrico Pereira Rossell (HP-CHPR). Metodologia: estudo transversal descritivo de crianças hospitalizadas tratadas com macrolídeos no HP-CHPR em 2018. Variáveis: tipo de macrolídeo, duração do tratamento, estudos e achados microbiológicos e diagnóstico no momento da alta. Resultados: 334 crianças receberam macrolídeos, idade mediana de 13 meses, 58,4% do sexo masculino. 71,0% internados em Unidade de Terapia Intensiva (UTI). A Claritromicina foi prescrita principalmente em 72,8% dos casos, nos últimos dois trimestres do ano (77,5%), devido a doença respiratória (94%): bronquiolite (23,3%), infecção aguda não especificada do trato respiratório inferior (21,9%) e crise de asma (19,1%). O tratamento médio incluiu Azitromicina e Claritromicina por 5 e 8 dias, respectivamente. Estudos microbiológicos foram realizados em 96,1% dos casos e 58,3% não evidenciaram a presença de microrganismos. Conclusões: destaca-se o uso de macrolídeos, principalmente em UTIs, e devido a patologias respiratórias. Os principais problemas identificados foram as prescrições feitas fora das atuais recomendações nacionais e a baixa confirmação microbiológica para sua utilização, o que sugere que é essencial definir estratégias para promover uma utilização mais racional destes antibióticos.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Drug Prescriptions/statistics & numerical data , Macrolides/administration & dosage , Anti-Bacterial Agents/administration & dosage , Respiratory Tract Infections/drug therapy , Uruguay/epidemiology , Child, Hospitalized , Cross-Sectional Studies , Clarithromycin/administration & dosage , Azithromycin/administration & dosage
8.
Animals (Basel) ; 12(5)2022 Feb 24.
Article in English | MEDLINE | ID: mdl-35268141

ABSTRACT

This study was carried out to evaluate the residual feed intake (RFI), volatile fatty acid (VFA) production and enteric methane (CH4) from growing Pelibuey sheep. In this case, 12 non-castrated Pelibuey with an initial average live weight (LW) of 21.17 ± 3.87 kg and an age of 3 months, were housed in individual pens and fed a basal diet with 16% of crude protein and 11 MJ ME for 45 days. Dry matter intake (DMI) was measured and the daily weight gain (DWG) was calculated using a linear regression between the LW and experimental period. Mean metabolic live weight (LW0.75) was calculated. RFI was determined by linear regression with DWG and LW0.75 as independent variables. Lambs were classified as low, medium, and high RFI. Feed efficiency was determined as DWG/DMI. For determining rumen pH, ammonia nitrogen concentration NH3-N), and VFA, ruminal fluid was obtained using an esophageal probe on day 40. Feed intake of low RFI lambs was approximately 16% lower (p < 0.05) while growth rate was not significantly different. Their average energy loss, expressed as CH4 production per kilogram of metabolic weight, was 17% lower (p < 0.05).

9.
Environ Manage ; 69(2): 438-448, 2022 02.
Article in English | MEDLINE | ID: mdl-35013793

ABSTRACT

Developing conservation strategies to mitigate cumulative impacts requires the understanding of historic land use and land cover changes at the regional scale. By using a multisensory and multitemporal approach, we identified the major changes driving cumulative impacts on native vegetation in northeastern Amazon. Comparing two regions, one with mining as the key driver and another where mining is associated with other industrial activities (cellulose), we explore the land use and land cover historic dynamics and derive implications for the assessment of cumulative impacts. Transitions of forest cover to pastureland, silviculture, and urban expansion were mapped in detail over a 20-year period, revealing that silviculture growth cleared more forests than pastureland expansion when associated with pulp mill activities and kaolin mining. In contrast, in a region with gold and iron mining, pastureland expansion was more relevant, clearing mainly areas surrounding new roads. This research shows that the interplay of major mining and industrial investments can produce cumulative losses of native vegetation, depending on the associated industries and infrastructure required for the project development. Our findings emphasize that the definition of spatial and temporal boundaries for the assessment of cumulative impacts must consider different trends in impact accumulation and changes in their spatial distribution over time.


Subject(s)
Conservation of Natural Resources , Forests , Brazil , Mining
10.
Appl Radiat Isot ; 170: 109608, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33540376

ABSTRACT

AIM: The aim of the present work was to determine if both ovariectomy (OVX) and type 2 diabetes mellitus (T2DM) can change X-ray absorptiometry until reach the osteoporosis condition. RESULTS: The segmentation allowed us to quantitatively determine the X-ray absorption in the femurs of mice subjected to OVX, T2DM and both pathologies together. CONCLUSIONS: The test subjects suffering from the mentioned pathologies separately or together, did not reach the osteoporosis condition when they were 30 weeks old.


Subject(s)
Diabetes Mellitus, Experimental/diagnostic imaging , Femur/diagnostic imaging , Ovariectomy , Absorptiometry, Photon , Animals , Bone Density , Diabetes Mellitus, Experimental/complications , Disease Models, Animal , Female , Mice , Osteoporosis/complications , Osteoporosis/diagnostic imaging
11.
Prev Med Rep ; 20: 101212, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33224718

ABSTRACT

Cervical cancer mortality is high among Peruvian women of reproductive age. Understanding barriers and facilitators of cervical cancer screening and treatment could facilitate development of contextually-relevant interventions to reduce cervical cancer incidence and mortality. From April to October 2019, we conducted a cross-sectional survey with 22 medical personnel and administrative staff from Liga Contra el Cancer, in Lima, Peru. The survey included structured and open-ended questions about participants' roles in cervical cancer prevention and treatment, perceptions of women's barriers and facilitators for getting screened and/or treated for cervical cancer, as well as attitudes towards adopting new cervical cancer interventions. For structured questions, the frequency of responses for each question was calculated. For responses to open-ended questions, content analysis was used to summarize common themes. Our data suggest that the relative importance and nature of barriers that Peruvian women face are different for cervical cancer screening compared to treatment. In particular, participants mentioned financial concerns as the primary barrier to treatment and a lack of knowledge or awareness of human papillomavirus and/or cervical cancer as the primary barrier to screening uptake among women. Participants reported high willingness to adopt new interventions or strategies related to cervical cancer. Building greater awareness about benefits of cervical cancer screening among women, and reducing financial and geographic barriers to treatment may help improve screening rates, decrease late-stage diagnosis and reduce mortality in women who have a pre-cancer diagnosis, respectively. Further studies are needed to generalize study findings to settings other than Lima, Peru.

12.
Appl Radiat Isot ; 146: 61-65, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30753986

ABSTRACT

The aim of this work was to calculate S values for 99mTc, 67Ga, 68Ga, 18F, 223Ra, 166Ho, 90Y, 161Tb 131I and 177Lu, using a mouse phantom (MOBY) standard and considering the anatomic sizes from males and females, the simulation of radiation transport was performed with GATE/Geant4 platform. This indicates that in the internal dosimetry the use of a customized geometry is relevant for each gender and a standard model is not a good choice.


Subject(s)
Radioisotopes/pharmacokinetics , Radioisotopes/therapeutic use , Animals , Computer Simulation , Female , Humans , Male , Mice , Models, Animal , Organ Size , Organ Specificity , Phantoms, Imaging , Radiation Dosage , Radiometry/methods , Sex Characteristics
13.
Eur Geriatr Med ; 10(3): 493-500, 2019 Jun.
Article in English | MEDLINE | ID: mdl-34652786

ABSTRACT

OBJECTIVE: To determine the association of Borrelia burgdorferi infection with Alzheimer's disease or mild cognitive impairment (MCI) in older adults. METHODS: Case-control study. Patients older than 60 years, both sexes, were included. Three groups were created: with probable Alzheimer's disease cases with NINCDS-ADRDA criteria, MCI cases in those not meeting NINCDS-ADRDA criteria for dementia, but who had an abnormal cognitive evaluation and independence in instrumental activities of daily living (IADL), cognitively healthy controls were diagnosed with normal cognitive evaluation and independence in IADL were identified in the community. Western blot IgG against B. burgdorferi in serum was done in all the participants. Non-conditional logistic regression was applied to estimate the association of Alzheimer's disease or MCI and seropositive to B. burgdorferi. RESULTS: Thirty-eight patients with Alzheimer's disease, mean age of 75.6 ± 3.4 years, 69% were females, education 8.3 ± 4.8 years. 39 patients with MCI, mean age of 72.2 ± 6.8 years, 85% were females, education 11.2 ± 4.2 years. A total of 11/38 (29%) were positive to B. burgdorferi with Alzheimer's disease, 9/39 (23%) with MCI, and 11/108 (10%) of controls. In patients with Alzheimer's disease, an adjusted odds ratio (aOR) = 3.65 (95% CI 1.2-11.1) adjusted for education and a history of cerebrovascular disease (CVD) was estimated, and in patients with MCI an aOR = 3.2 (95% CI 1.1-9.1) for a history of diabetes mellitus and CVD was estimated. CONCLUSIONS: In our study, there was an increased risk of Alzheimer's disease and MCI in seropositive IgG patients to B. burgdorferi.

14.
Environ Manage ; 62(5): 929-941, 2018 11.
Article in English | MEDLINE | ID: mdl-30039241

ABSTRACT

Cumulative effects assessment (CEA), as a required practice for the environmental assessment (EA) of projects in many countries, faces several practical challenges, especially related to biodiversity. Drawing on the perspectives and experiences of Canadian EA practitioners, this paper explores options or drivers of change for improving project-based assessment to better tackle cumulative effects on biodiversity. An on-line survey was conducted with 40 professionals from the private sector, government departments/agencies, universities, and non-governmental organizations, examining the current challenges and opportunities regarding: CEA process for biodiversity; responsibilities for undertaking CEA tasks; resources to support and promote good CEA practice. In terms of process, there is shared understanding on: (i) the need of EA terms of reference to provide specific directions on CEA; (ii) CEA should capture both human and natural drivers of cumulative change; (iii) spatial boundaries for CEA should be based on ecological boundaries. There are dissenting views about: (i) whether CEA should consider all valued components (VCs) potentially affected by a project or only those for which residual effects are predicted; and (ii) delimitation of future temporal limits. In terms of responsibilities, participants agreed that project proponents should retain a central role in conducting CEA, but government agencies should lead the collection/provision of information about other projects in the study area and baseline VC conditions. Information and knowledge management resources could be also applied in the context of governmental agencies and consultancy firms to support CEA for biodiversity.


Subject(s)
Conservation of Natural Resources/methods , Environmental Monitoring/methods , Government Regulation , Private Sector , Biodiversity , Canada , Conservation of Natural Resources/legislation & jurisprudence , Environmental Monitoring/legislation & jurisprudence , Surveys and Questionnaires
15.
Rev Med Inst Mex Seguro Soc ; 55(Suppl 4): S419-S424, 2017.
Article in Spanish | MEDLINE | ID: mdl-29799712

ABSTRACT

Background: Guillain-Barré Syndrome (GBS) is an acute polyneuropathy characterized by symmetrical weakness of the limbs with hyporeflexia or areflexia with a maximum progression within four weeks and can impair respiratory function and implies disability at a long. The aim of this paper was to describe the clinical, epidemiological and neurophysiological features of patients with GBS at the Hospital de Especialidades del Centro Medico Nacional Siglo XXI (HECMNSXXI) Methods: An observational, retrospective cross-sectional study, data were collected form clinical records of adults with GBS hospitalized in HECMNSXXI from March 2012 to March 2016. The recorded variables were demographics, previous infection, clinical presentation, disability scores, prognosis scores and neurophysiological subtypes. Results: Clinical records of 94 patients were analysed with a mean age of 53 years, 61% male, with previous infection in 80%. Albumin cytologic dissociation was present in 50%. Medical Research Council (MRC) sum scores mean was 32, the SGB disability score at admittance with a mean of 3.63. The axonal subtype was in 68%, and demyelinating in 29%, not conclusive in 3%. Conclusions: In this study the demographic and clinical features are similar to other previous reports, we documented a greater proportion of axonal subtype, which are related with important disability and worse prognosis.


Introducción: El síndrome de Guillain-Barré (SGB) es una polirradiculoneuropatía aguda caracterizada por debilidad simétrica progresiva de las extremidades con hipo o arreflexia, que progresa en un máximo de 4 semanas y que puede llevar a la falla respiratoria y a discapacidad a largo plazo. El objetivo de este trabajo fue describir las características clínicas, epidemiológicas y neurofisiológicas de pacientes con SGB del Hospital de Especialidades del Centro Médico Nacional Siglo XXI (HECMNSXXI). Métodos: Se realizó un estudio observacional de tipo transversal retrolectivo. Se obtuvieron datos de expedientes clínicos de adultos con diagnóstico de SGB hospitalizados en el HECMNSXXI en el periodo de marzo de 2012 a marzo de 2016. Se registraron variables demográficas, clínicas y neurofisiológicas. Resultados: Se incluyeron 94 pacientes con un promedio de edad de 53 años, en su mayoría hombres, con infección previa en 80%. La fuerza muscular medida con la escala del Medical Research Council (MRC) fue en promedio de 32, la escala de discapacidad del SGB (Hughes) al ingreso tuvo un promedio de 3.63. La variedad axonal se encontró en 68%, la desmielinizante en 29% y en 3% no concluyente. Conclusiones: Se documentan en esta muestra características demográficas y clínicas similares a lo reportado en la literatura, así como la mayor proporción de variedades axonales, las cuales tienen mayor severidad en la presentación clínica así como mal pronóstico.


Subject(s)
Guillain-Barre Syndrome/diagnosis , Adult , Aged , Cross-Sectional Studies , Female , Guillain-Barre Syndrome/epidemiology , Guillain-Barre Syndrome/physiopathology , Humans , Male , Mexico/epidemiology , Middle Aged , Retrospective Studies , Tertiary Care Centers
16.
Estud. av ; 31(89): 167-183, 2017.
Article in Portuguese | LILACS | ID: biblio-875237

ABSTRACT

Embora discutida em certos círculos acadêmicos e governamentais há mais de vinte anos, a Avaliação Ambiental Estratégica (AAE) pouco avança no país. São conhecidos cerca de 40 AAE, mas seus resultados são pífios, se considerada sua influência sobre processos decisórios. A AAE não deveria estar limitada a planos, programas ou políticas de setores cujos principais projetos já são objeto de licenciamento ambiental, mas voltada primordialmente para políticas públicas cujas consequências socioambientais são hoje amplamente ignoradas, a exemplo das macroeconômicas. Para avançar, é preciso evidenciar as vantagens da AAE para os tomadores de decisão e encontrar formas de superar a desconfiança que tem os políticos, em todos os níveis de governo, de um processo que percebem como redutor de sua margem de discrição e poder decisório. Inevitavelmente, a AAE exige maior transparência e melhor governança. Esse é o grande obstáculo à sua adoção no Brasil.(AU)


Strategic Environmental Assessment (SEA) has been discussed for many years in Brazil. Despite the fact that about 40 such assessments have been conducted so far, their outcomes have been piddling if we consider their actual influence in decision-making. SEA should not be limited to plans, programs or policies in economic sectors where major projects already require mandatory environmental impact assessments, but rather aimed primarily at public policies whose social and environmental consequences are barely known or largely ignored, such as macroeconomic policies. The value of SEA to decision-makers must be demonstrated to overcome distrust, especially among politicians who perceive SEA as reducing their discretionary power. Inevitably, SEA requires more transparency and better governance. That is biggest hurdle to its effective implementation in Brazil.(AU)


Subject(s)
Humans , Male , Female , Environment , Environment Design , Environmental Quality , Evaluation Study , Health Strategies , Decision Making , Government Programs , Quality of Life , Sustainable Development Indicators
17.
Saúde Soc ; 25(4): 1075-1094, out.-dez. 2016. tab, graf
Article in Portuguese | LILACS | ID: biblio-962495

ABSTRACT

Resumo Audiências públicas são o principal mecanismo para participação em processos de licenciamento ambiental no Brasil. Criadas para informar e ouvir o público, as audiências são criticadas por sua baixa capacidade de influenciar decisões, atribuída, entre outros fatores, à realização tardia no processo de licenciamento. Buscando explorar essa temática em um setor no qual a participação pública é pouco estudada, foi realizada análise documental de 25 audiências públicas de processos de licenciamento ambiental para implantação ou ampliação de usinas de cana-de-açúcar em São Paulo. A maioria dos 62 participantes que fizeram uso da palavra são cidadãos, seguidos de representantes do Poder Executivo e de representantes de entidades da sociedade civil. Quanto às características das falas, 50,9% foram afirmações/comentários, 15,2% ressaltaram aspectos positivos do projeto/empresa, 11,2% apresentaram questionamentos, 9,4% destacaram aspectos negativos, 5,4% apresentaram sugestões, 6,5% foram de endosso ao projeto e 1,4% de oposição. Quanto aos temas abordados, geração de emprego e renda e a reputação da empresa são os mais frequentes, destacados majoritariamente em seus aspectos positivos. Estes temas diferem daqueles destacados na literatura como relevantes para discutir os impactos da expansão da cana-de-açúcar, mostrando a diferença entre a apreciação popular e a técnico-científica dos impactos socioambientais.


Abstract Public hearings are the primary mechanism for public participation in Brazilian environmental licensing. Created to inform and listen to the public, the hearings are criticized for their low influence on decision-making, resulting, among other reasons, from its late occurrence in the licensing process. Seeking to explore the theme in a sector where public participation is not usually researched, this paper presents an analysis of 25 public hearings about the process of environmental licensing of sugarcane mills in the state of São Paulo, Brazil. Most of the 62 participants are citizens, followed by representatives of local governments and representatives of civil society organizations. Regarding the characteristics of speeches, 50.9% were statements/comments, 15.2% highlighted positive aspects of the project/company, 11.2% were questions, 9.4% highlighted negative aspects, 5.4% were suggestions; 6.5% were for endorsing the project, and 1.4% for opposing. As for themes, employment and income generation and the company's reputation are the most frequent, highlighted mainly for its positive aspects. These themes differ from those discussed in the literature as relevant for sugarcane expansion impact, showing a marked difference between citizens' and scientists' perspectives about its social and environmental consequences.


Subject(s)
Humans , Male , Female , Environmental Health/legislation & jurisprudence , Environment , Community Participation , Saccharum , Human Rights , Industry
18.
Rev. cuba. salud pública ; 38(1): 54-63, enero-marzo 2012.
Article in Spanish | LILACS | ID: lil-625578

ABSTRACT

Introducción: en la práctica médica se han creado, desde hace décadas, instrumentos que persiguen modificar y mejorar la condición previa a la cirugía. Objetivo: mejorar la evaluación preoperatoria en pacientes incluidos en el programa de cooperación Misión Milagro. Métodos: se realizó un estudio descriptivo retrospectivo, en el Hospital-Hotel Pasacaballos, Cienfuegos, donde se evaluaron 7 956 pacientes de 12 países de América Latina y del Caribe, desde septiembre 2005 hasta abril 2007. Para la evaluación preoperatoria se propuso una metodología en cuatro etapas confeccionada en el centro. Se tomaron los siguientes datos de la base de datos en la institución: estado físico del paciente, causas del aplazamiento de la intervención, causas de cancelación por especialidades y enfermedad oftalmológica del paciente. Resultados: predominaron los pacientes clasificados en el tipo II, 55,8 porciento, según la Sociedad de Anestesia de los Estados Unidos de América. Las causas principales de aplazamiento de la cirugía fueron secreción ocular (22,6 porciento de los aplazados), hipertensión ocular (19,5 porciento), ingestión de aspirina (17,2 porciento) y diabetes mellitus descompensada (12,4 porciento). Se declararon no aptos para la intervención quirúrgica, 899 pacientes por oftalmología y 37 por medicina interna. Conclusiones: la metodología propuesta contribuye a mejorar la asistencia médica preoperatoria en pacientes incluidos en el programa de cooperación Misión Milagro en Cienfuegos


Introduction: for decades, instruments aimed at changing and improving the patient's condition before surgery have been created in the medical practice. Objective: to improve the preoperative evaluation of patients included in the Miracle Mission cooperation program. Methods: a retrospective and descriptive study was conducted at the hotel-hospital located in Pasacaballos, Cienfuegos, in which 7 956 patients from 12 Latin American and Caribbean countries were evaluated from September, 2005 to April, 2007. A customized four-phased methodology was submitted to evaluate preoperatively. The center's database provided the following pieces of information: physical status, causes of surgery postponement, causes of surgery cancellation by specialty and eye disease of the patient. Results: type II-classified patients predominated (55.8 percent), according to criteria of the US Society of Anesthesiology). The main causes of surgery postponement were ocular secretion (22.6 percent of the postponed cases), ocular hypertension (19.5 percent), aspirin taking (17.2 percent) and decompensate diabetes mellitus (12.4 percent). Eight hundred and ninety nine patients and thirty seven patients were considered non-eligible for surgery due to ophthalmological and internal medicine reasons respectively. Conclusions: The submitted methodology contributes to improving the preoperative medical care for patients included in the Miracle Mission cooperation program in Cienfuegos province. The achieved results suggested that it can be useful in limited financial resource settings


Subject(s)
Blindness/surgery , Preoperative Care
19.
Rev. cuba. salud pública ; 38(1)enero-marzo 2012.
Article in Spanish | CUMED | ID: cum-51221

ABSTRACT

Introducción: en la práctica médica se han creado, desde hace décadas, instrumentos que persiguen modificar y mejorar la condición previa a la cirugía. Objetivo: mejorar la evaluación preoperatoria en pacientes incluidos en el programa de cooperación Misión Milagro. Métodos: se realizó un estudio descriptivo retrospectivo, en el Hospital-Hotel Pasacaballos, Cienfuegos, donde se evaluaron 7 956 pacientes de 12 países de América Latina y del Caribe, desde septiembre 2005 hasta abril 2007. Para la evaluación preoperatoria se propuso una metodología en cuatro etapas confeccionada en el centro. Se tomaron los siguientes datos de la base de datos en la institución: estado físico del paciente, causas del aplazamiento de la intervención, causas de cancelación por especialidades y enfermedad oftalmológica del paciente. Resultados: predominaron los pacientes clasificados en el tipo II, 55,8 porciento, según la Sociedad de Anestesia de los Estados Unidos de América. Las causas principales de aplazamiento de la cirugía fueron secreción ocular (22,6 porciento de los aplazados), hipertensión ocular (19,5 porciento), ingestión de aspirina (17,2 porciento) y diabetes mellitus descompensada (12,4 porciento). Se declararon no aptos para la intervención quirúrgica, 899 pacientes por oftalmología y 37 por medicina interna. Conclusiones: la metodología propuesta contribuye a mejorar la asistencia médica preoperatoria en pacientes incluidos en el programa de cooperación Misión Milagro en Cienfuegos(AU)


Introduction: for decades, instruments aimed at changing and improving the patient's condition before surgery have been created in the medical practice. Objective: to improve the preoperative evaluation of patients included in the Miracle Mission cooperation program. Methods: a retrospective and descriptive study was conducted at the hotel-hospital located in Pasacaballos, Cienfuegos, in which 7 956 patients from 12 Latin American and Caribbean countries were evaluated from September, 2005 to April, 2007. A customized four-phased methodology was submitted to evaluate preoperatively. The center's database provided the following pieces of information: physical status, causes of surgery postponement, causes of surgery cancellation by specialty and eye disease of the patient. Results: type II-classified patients predominated (55.8 percent), according to criteria of the US Society of Anesthesiology). The main causes of surgery postponement were ocular secretion (22.6 percent of the postponed cases), ocular hypertension (19.5 percent), aspirin taking (17.2 percent) and decompensate diabetes mellitus (12.4 percent). Eight hundred and ninety nine patients and thirty seven patients were considered non-eligible for surgery due to ophthalmological and internal medicine reasons respectively. Conclusions: The submitted methodology contributes to improving the preoperative medical care for patients included in the Miracle Mission cooperation program in Cienfuegos province. The achieved results suggested that it can be useful in limited financial resource settings(AU)


Subject(s)
Preoperative Care , Blindness/surgery
20.
J Environ Manage ; 92(9): 2260-71, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21592648

ABSTRACT

How does knowledge management (KM) by a government agency responsible for environmental impact assessment (EIA) potentially contribute to better environmental assessment and management practice? Staff members at government agencies in charge of the EIA process are knowledge workers who perform judgement-oriented tasks highly reliant on individual expertise, but also grounded on the agency's knowledge accumulated over the years. Part of an agency's knowledge can be codified and stored in an organizational memory, but is subject to decay or loss if not properly managed. The EIA agency operating in Western Australia was used as a case study. Its KM initiatives were reviewed, knowledge repositories were identified and staff surveyed to gauge the utilisation and effectiveness of such repositories in enabling them to perform EIA tasks. Key elements of KM are the preparation of substantive guidance and spatial information management. It was found that treatment of cumulative impacts on the environment is very limited and information derived from project follow-up is not properly captured and stored, thus not used to create new knowledge and to improve practice and effectiveness. Other opportunities for improving organizational learning include the use of after-action reviews. The learning about knowledge management in EIA practice gained from Western Australian experience should be of value to agencies worldwide seeking to understand where best to direct their resources for their own knowledge repositories and environmental management practice.


Subject(s)
Environment , Environmental Monitoring/methods , Government Agencies/organization & administration , Knowledge Management , Databases, Factual , Learning , Western Australia
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